Department of Orthopaedic Surgery, Katholisches Klinikum Bochum, Martin-Luther-Hospital, Voedestrasse 79, 44866, Bochum, Germany.
J Orthop Surg Res. 2021 Feb 27;16(1):163. doi: 10.1186/s13018-021-02297-6.
Heterotopic ossifications are a common complication after total hip arthroplasty. Low-dose radiation therapy and non-steroidal anti-inflammatory drugs have proven to effectively reduce the rate of heterotopic ossification after total hip arthroplasty. However, a low number of studies describe an equal efficiency of etoricoxib. This work shows first results on the examination of a larger group with 194 subjects to analyze efficiency and rate of side effects under treatment with etoricoxib.
Clinical examinations were performed the day before surgery and after at least 12 months. The survey of clinical and functional outcome was done with Harris Hip Score (HHS). Conventional antero-posterior radiographs and second plane in frog leg position were assessed.
In total, 14 undesirable side effects (7.4%) and only four early terminations of therapy (2.1%) were documented. A complete 1-year follow-up examination including radiographs could be done in 143 subjects (79.4%). Only 28 subjects (19.6%) developed heterotopic ossifications from which 92.9% were classified in type 1 and 7.1% in type 2 using the method described by Brooker. The results do not show correlations with body mass index, extended treatment (more than ten days), or clinical and functional outcome (measured by "Harris Hip Score"). However, male subjects show a significantly higher rate of heterotopic ossifications.
The investigations presented in this study confirm a good efficiency of etoricoxib for the prevention of heterotopic ossifications in comparison with classical methods such as radiation or drug therapy and show a low rate of undesirable side effects.
异位骨化是全髋关节置换术后的常见并发症。低剂量放射治疗和非甾体抗炎药已被证明能有效降低全髋关节置换术后异位骨化的发生率。然而,很少有研究描述依托考昔的等效效率。这项工作首次展示了对 194 名受试者进行更大规模检查的结果,以分析依托考昔治疗的效率和副作用发生率。
术前和至少 12 个月后进行临床检查。采用 Harris 髋关节评分(HHS)评估临床和功能结局。评估常规前后位 X 线片和蛙腿位第二平面。
共记录到 14 例不良副作用(7.4%)和 4 例早期终止治疗(2.1%)。143 名受试者(79.4%)完成了包括 X 线片的完整 1 年随访检查。仅 28 名受试者(19.6%)发生异位骨化,其中 92.9%根据 Brooker 方法分类为 1 型,7.1%为 2 型。结果与体重指数、延长治疗(超过 10 天)或临床和功能结局(用“Harris 髋关节评分”测量)无关。然而,男性受试者的异位骨化发生率明显更高。
本研究中的调查结果证实,依托考昔在预防异位骨化方面的效率优于经典方法,如放射治疗或药物治疗,且不良副作用发生率较低。